Abstract
BackgroundEthnic differences have been reported in cardiovascular disease (CVD) risk factors. It is still unclear which ethnic groups are most at risk for CVD when all traditional CVD risk factors are considered together as overall risk.ObjectivesTo examine ethnic differences in overall estimated CVD risk and the risk factors that contribute to these differences.DesignUsing data of the multi-ethnic HELIUS study (HEalthy LIfe in an Urban Setting) from Amsterdam, we examined whether estimated CVD risk and risk factors among those eligible for CVD risk estimation differed between participants of Dutch, South Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan origin. Using the Systematic COronary Risk Evaluation (SCORE) algorithm, we estimated risk of fatal CVD and risk of fatal plus non-fatal CVD. These risks were compared between ethnic groups via age-adjusted linear regression analyses.ResultsThe SCORE algorithm was applicable to 9,128 participants. Relative to the fatal CVD risk of participants of Dutch origin, South Asian Surinamese participants showed a higher fatal CVD risk, Ghanaian males a lower fatal CVD risk, and participants of other ethnic origins a similar fatal CVD risk. For fatal plus non-fatal CVD risk, African Surinamese and Turkish men also showed a higher risk. When diabetes was incorporated in the CVD risk algorithm, all but Ghanaian men showed a higher CVD risk relative to the participants of Dutch origin (betas ranging from 0.98–3.10%). The CVD risk factors that contribute the most to these ethnic differences varied between ethnic groups.ConclusionEthnic minority groups are at a greater estimated risk of fatal plus non-fatal CVD relative to the group of native Dutch. Further research is necessary to determine whether this will translate to ethnic differences in CVD incidence and, if so, whether ethnic-specific CVD prevention strategies are warranted.Electronic supplementary materialThe online version of this article (10.1007/s12471-018-1107-3) contains supplementary material, which is available to authorized users.
Highlights
Cardiovascular disease (CVD) is one of the leading causes of mortality and morbidity and is distributed unequally among ethnic groups [1,2,3,4]
● Estimated fatal cardiovascular disease risk is similar between the population of Dutch origin and most ethnic minority groups
● for non-fatal cardiovascular disease the estimated risk is higher among most ethnic minority groups relative to the group of Dutch origin
Summary
Cardiovascular disease (CVD) is one of the leading causes of mortality and morbidity and is distributed unequally among ethnic groups [1,2,3,4]. Targeted CVD prevention strategies are based on identifying high-risk individuals [1, 5]. CVD risk is often defined as the ten-year risk of mortality due to coronary heart disease or stroke, which can be estimated by CVD risk algorithms based on the occurrence of CVD risk factors [1, 5]. Based on the estimated CVD risk, the initiation of preventive intervention can be tailored to the individual [1, 5]. Ethnic differences have been reported in cardiovascular disease (CVD) risk factors. It is still unclear which ethnic groups are most at risk for CVD when all traditional CVD risk factors are considered together as overall risk
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